St. Mary's Religious Education 2019-2020 Online Registration
Please complete the following online form to register your child(ren) for 2019/2020 religious education classes through the St. Mary's Religious Education Program. You may pay in the form of a check made out to "St. Mary's Church" and drop it off to the rectory. PAYMENT IS DUE AT THE TIME OF REGISTRATION. If you have questions, please contact the rectory at 815-467-2769.

THIS ONLINE FORM ALLOWS YOU REGISTER UP TO THREE CHILDREN. IF YOU ARE REGISTERING MORE THAN THREE CHILDREN, PLEASE FEEL FREE TO COMPLETE THIS ONLINE FORM MULTIPLE TIMES AS NEEDED OR PICK-UP A REGISTRATION PACKET AT THE RECTORY AND REGISTER ALL YOUR CHILDREN ON THE HARDCOPY FORM.

Family Name *
Your answer
Family email *
Your answer
Father Name *
Your answer
Mothers Name *
Your answer
Mother's Maiden Name *
Your answer
Address *
Your answer
Street Name *
Your answer
Town *
Your answer
Zip Code *
Your answer
Is the address listed above a new address (applicable only if your child attended RE classes with St. Mary's last year) *
Preferred Phone Number
Your answer
Emergency Contact *
Your answer
Emergency Contact Phone number *
Your answer
Are you a registered parishioner? You must be a registered parishioner to enroll in the St. Mary's Religious Education Program. *
Were your children in our program last year? *
FOR GRADES K THROUGH 5TH - Please choose one of the following options. Classes will be assigned on a first-come, first-served basis (limit 15 students per class) K will be on Wednesday Only *
FOR 6TH - 8TH GRADE *
CHILD #1 - Name (First, Middle, and Last) *
Your answer
CHILD #1 - Gender *
CHILD #1 - Grade in 2019/2020 *
CHILD #1 - Date of Birth & Place of Birth *
Your answer
CHILD #1 - Has your child received the following Sacraments? *
Yes
No
Baptism
Reconcilliation
First Communion
Confirmation
CHILD #2 - Name (First, Middle, and Last) - SKIP IF YOU ARE NOT REGISTERING A SECOND CHILD
Your answer
CHILD #2 - Gender - SKIP IF YOU ARE NOT REGISTERING A SECOND CHILD
CHILD #2 - Grade in 2019 - 2020- SKIP IF YOU ARE NOT REGISTERING A SECOND CHILD
CHILD #2 - Date of Birth & Place of Birth - SKIP IF YOU ARE NOT REGISTERING A SECOND CHILD
Your answer
CHILD #2 - Has your child received the following Sacraments? - SKIP IF YOU ARE NOT REGISTERING A SECOND CHILD
Yes
No
Baptism
Reconcilliation
First Communion
Confirmation
CHILD #3 - Name (First, Middle, and Last) - SKIP IF YOU ARE NOT REGISTERING A THIRD CHILD
Your answer
CHILD #3 - Gender - SKIP IF YOU ARE NOT REGISTERING A THIRD CHILD
CHILD #3 - Grade in 2019- 2020 - SKIP IF YOU ARE NOT REGISTERING A THIRD CHILD
CHILD #3 - Date of Birth & Place of Birth - SKIP IF YOU ARE NOT REGISTERING A THIRD CHILD
Your answer
CHILD #3 - Has your child received the following Sacraments? - SKIP IF YOU ARE NOT REGISTERING A THIRD CHILD
Yes
No
Baptism
Reconcilliation
First Communion
Confirmation
In the space below, please list the FIRST AND LAST NAME OF EACH CHILD YOUR ARE REGISTERING on this form, the DATE OF EACH CHILD'S BAPTISM, and the PARISH AT WHICH EACH CHILD WAS BAPTIZED (example: John Doe / January 29, 2011 / St. Mary's Minooka). If you have a child entering our program for the first time or if you have not yet turned in a baptismal certificate for your child(ren), please drop-off a copy of his/their baptismal certificate(s) to the rectory as soon as possible. *
Your answer
How will your child(ren) be picked up from Religious Education classes? Please send a note on the first day of class with any particular pick-up instructions). *
If any of the students listed on this form have any special needs (learning, behavior, health, etc.) of which we should be aware for the purpose of placement or scheduling, please indicate in the space below? This information will be kept confidential.
Your answer
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